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About:
A shared protocol for porcine surfactant use in pediatric acute respiratory distress syndrome: a feasibility study
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wasabi.inria.fr
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Academic Article
research paper
schema:ScholarlyArticle
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Academic Article
research paper
schema:ScholarlyArticle
isDefinedBy
Covid-on-the-Web dataset
has title
A shared protocol for porcine surfactant use in pediatric acute respiratory distress syndrome: a feasibility study
Creator
Piastra, Marco
De Silvestri, Annalisa
Amigoni, Angela
Conti, Giorgio
D'amato 11, Luigia
Gitto, Eloisa
Mondardini, Maria
Montani, Cinzia
Pizzi, Simone
Rossetti, Emanuele
Santuz, Pierantonio
Savron, Fabio
Tinelli, Carmine
Wolfler, Andrea
Source
PMC
abstract
BACKGROUND: Pediatric ARDS still represents a difficult challenge in Pediatric Intensive Care Units (PICU). Among different treatments proposed, exogenous surfactant showed conflicting results. Aim of this multicenter retrospective observational study was to evaluate whether poractant alfa use in pediatric ARDS might improve gas exchange in children less than 2 years old, according to a shared protocol. METHODS: The study was carried out in fourteen Italian PICUs after dissemination of a standardized protocol for surfactant administration within the Italian PICU network. The protocol provides the administration of surfactant (50 mg/kg) divided in two doses: the first dose is used as a bronchoalveolar lavage while the second as supplementation. Blood gas exchange variations before and after surfactant use were recorded. RESULTS: Sixty-nine children, age 0–24 months, affected by Acute Respiratory Distress Syndrome treated with exogenous porcine surfactant were enrolled. Data collection consisted of patient demographics, respiratory variables and arterial blood gas analysis. The most frequent reasons for PICU admission were acute respiratory failure, mainly bronchiolitis and pneumonia, and septic shock. Fifty-four children (78.3%) had severe ARDS (define by oxygen arterial pressure and inspired oxygen fraction ratio (P/F) < 100), 15 (21.7%) had moderate ARDS (100 < P/F < 200). PO(2), P/F, Oxygenation Index (OI) and pH showed a significant improvement after surfactant use with respect to baseline (p < 0.001 at each included time-point for each parameter). No significant difference in blood gas variations were observed among four different subgroups of diseases (bronchiolitis, pneumonia, septic shock and others). Overall, 11 children died (15.9%) and among these, 10 (90.9%) had complex chronic conditions. Two children (18.2%) died while being treated with Extracorporeal Membrane Oxygenation (ECMO). Mortality for severe pARDS was 20.4%. CONCLUSION: The use of porcine Surfactant improves oxygenation, P/F ratio, OI and pH in a population of children with moderate or severe pARDS caused by multiple diseases. A shared protocol seems to be a good option to obtain the same criteria of enrollment among different PICUs and define a unique way of use and administration of the drug for future studies.
has issue date
2019-06-18
(
xsd:dateTime
)
bibo:doi
10.1186/s12887-019-1579-3
bibo:pmid
31215483
has license
cc-by
sha1sum (hex)
efe9c08c881908c9a617c23c8b0ae9e8c7307dbd
schema:url
https://doi.org/10.1186/s12887-019-1579-3
resource representing a document's title
A shared protocol for porcine surfactant use in pediatric acute respiratory distress syndrome: a feasibility study
has PubMed Central identifier
PMC6580470
has PubMed identifier
31215483
schema:publication
BMC Pediatr
resource representing a document's body
covid:efe9c08c881908c9a617c23c8b0ae9e8c7307dbd#body_text
is
schema:about
of
named entity 'ARDS'
named entity 'respect'
named entity 'blood gas'
named entity 'Blood gas'
named entity 'variations'
named entity 'drug'
named entity 'porcine'
named entity 'acute respiratory distress syndrome'
named entity 'CONFLICTING'
named entity 'BRONCHIOLITIS'
named entity 'PARDS'
named entity 'COMPLEX'
named entity 'SECOND'
named entity 'OXYGENATION'
named entity 'BLOOD GAS'
named entity 'PORACTANT ALFA'
named entity 'ADMINISTRATION'
named entity 'MORTALITY'
named entity 'SIXTY-NINE'
named entity 'REASONS'
named entity 'VARIATIONS'
named entity 'SEVERE'
named entity '28P'
named entity 'BACKGROUND'
named entity 'EXTRACORPOREAL MEMBRANE OXYGENATION'
named entity 'SIGNIFICANT'
named entity 'FOURTEEN'
named entity 'DOSES'
named entity 'BRONCHOALVEOLAR LAVAGE'
named entity 'DIED'
named entity 'FIFTY'
named entity 'acute respiratory failure'
named entity 'variables'
named entity 'pediatric'
named entity 'surfactant'
named entity 'arterial blood gas'
named entity 'children'
named entity 'protocol'
named entity 'define'
named entity 'oxygen'
named entity 'ratio'
named entity 'evaluate'
named entity 'ARDS'
named entity 'Pediatric'
named entity 'Pediatric'
named entity 'surfactant'
named entity 'PICU'
named entity 'surfactant'
named entity 'PICU'
named entity 'PICU'
named entity 'pediatric'
named entity 'Intensive Care Units'
named entity 'chronic conditions'
named entity 'oxygen'
named entity 'pediatric acute respiratory distress syndrome'
named entity 'admission'
named entity 'bronchiolitis'
named entity 'arterial blood gas'
named entity 'ventilatory support'
named entity 'severe respiratory failure'
named entity 'chronic condition'
named entity 'nutrition'
named entity 'respiratory failure'
named entity 'Berlin'
named entity 'demographic characteristics'
named entity 'Odds Ratio'
named entity 'STATA'
named entity 'gas exchange'
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